Friday, May 29, 2009

NUCCA? Whazzat?

Alas, another post that is only peripherally, and by your indulgence, related to the subject of writing.

Before our little jaunt to Hawaii, I thought my blood pressure was under control. Mornings it tended to be about 124/82; after yoga, this dropped to about 105/70 and tended to stay there for the rest of the day.

That changed in Hawaii, and for no discernible reason. Although a good yoga session in Honolulu still dropped my blood pressure an hour or two later to about 95/60, at odd moments earlier or much later in the day, it might go higher, up into the 140s/90s. And, on the night before we came home, it went very high indeed. We're not talking Dow-Jones-Industrials sort of high; but we're definitely talking numbers that, were they IQ scores, would get you into MENSA no questions asked.

This weirdness has persisted. Yoga invariable puts it below 105/70, but at other times I can get measurements as high as 170/105. There appears to be no particular pattern--although, of course, having something stressful happen will make it rise sharply. For example, yesterday I came home from a morning yoga class with a blood pressure of 91/53; after responding to a particularly upsetting e-mail, it had jumped to 165/100. (Unfortunately, the reverse is not true; relaxing doesn't necessarily make it come down.)

One decision I've made is not to read any e-mails I don't absolutely have to read. Another is that I have decided to drop out of my annual writing retreat in Palm Desert. This was wrenching; it's one of my favorite events of the year, and I look forward to it every summer. But things are so damn strange with me physically at the moment that I'm simply not up to it.

(There, see? I talked about writing. Sorta.)

This "labile" blood pressure is considered a very bad sign; but, then, it's usually seen in the latter stages of heart failure, which is certainly not what is happening to me. It's more than a little baffling--and would continue to be disturbing even if I manage to coax my blood pressure into the nice stable pattern I had before my recent unrelaxing vacation.

In searching the web for information, I came across a technique called NUCCA that has normalized blood pressure in a number of people. Now, as a Californian native, I know about "YUCCA," a large spiny flowering member of the agave family (and, weirdly enough, technically a sort of lily). But "NUCCA?"

As it turns out, NUCCA is the National Upper Cervical Chiropractic Association, a group that specializes in adjustments of the cerivcal spine, and, in particular, the so-called Atlas vertebra that supports the head where the brainstem narrows down into the spinal column.

It seems that a Chicago doctor had been sending a number of his patients to a NUCCA chiropractor for various kinds of pain, and he noticed that the patients who suffered from high blood pressure came back with their blood pressures substantially reduced and sometimes normalized. (He had to take a number of then off of their medications.)

This doctor contacted a the director of the Hypertension center at the University of Chicago, and together they proceeded to conduct a well-designed, double-blind study where neither patients nor doctors knew whether the NUCCA chirpractor on the research team study had given the patient an actual adjustment or a sham adjustment. The results were stunning, and also unassailable--despite the medical prejudice against chiropractic, the results were published in a majore medical journal and now seem set for a wider-scale trial.

"Is it going to be for everybody with high blood pressure? No," the lead researcher said. "We clearly need to identify those who can benefit. It is pretty clear that some kind of head or neck trauma early in life is related to this."

Well, as it happens, I am a survivor of pretty major neck trauma. When I was 17, I took a fall from a building that left me with a broken collarbone. The collarbone was treated, but the damage to neck was ignored. The disc between two of the cerivcal vertebrae was crushed so completely that the two vertebrae fused together, and the vertebrae directly above and below them aren't much better off. (I'm probably an inch shorter than I was when I was 17.) Doctors wince when they look at my x-rays.

This has been a source of ongoing pain in my shoulder, my back, my neck, and my left arm, and not just mild pain, either; but you can get used to pretty much anything. I wasn't worried about the pain, but I was hoping that NUCCA could do something about my fluctuating blood pressure.

Pamela, always the scientist, was somewhat excited by the idea, noting that the odd way my blood pressure fluctuated, and the fact that it responded so strongly to aggressive yoga (but almost not at all to other aerobic exercise) suggested a problem that was mechanical rather than chemical in nature. So, off I went in search of a NUCCA adjustment.

Now, not just any chiropractor can do this sort of adjustment. NUCCA is a very narrow, very precise set of techniques that has little connection with what people think of as chiropractic. They don't twist or shove, and above all the NUCCA techniques don't call for popping or cracking joints. Instead, a NUCCA practitioner takes a number of x-rays and then does a rather arcane series of calculations to determine how the bones in the neck (especially the all-important Atlas vertebra) need to be moved to return the body to alignment--and also to remove the pressure of the Atlas on the spinal cord.

As expected, my x-rays were a bit of a horror show. My Atlas was not only tilted but also revolved around my spinal cord; viewed in an x-ray looking down through the top of my head, you could almost see it pinching in on my brainstem. Nice.

The adjustments themselves are truly odd. You lay on your side, with your head supported on a strange little bench that can be cranked up and down to presie angles, and the doctor bends down over you and, well, sort of uses the edge of his hands to fiddle with your ear and jaw. Over and over again. What he in fact is doing is making small movements to lever your vertebrae relative to you skull, sort of as if he's "tapping" things back into place.

That part, at least, works. Even though it feels as if little has been done, the second set of x-rays show how much everything has moved. And my adjustment was unusually successful in terms of realignment.

Now the questions are 1) Will it have the desired effects? and 2) Will it stay adjusted?

Unlike most chiropractic work, this isn't designed to be a treatment that is repeated over and over; ideally it is a one-time adjustment that puts everything back where it ought to be. So I have to be very careful about my movements fro a few days, so as to let the body adjust and hopefully lock all the bones into their new positions. Unfortunately, this also means no yoga! (Ack! I'm going to have a hypertensive crisis!)

It's too early to tell if this will affect my blood pressure, since this takes time. But the effect on my arm, neck, shoulder and back has been dramatic. At one point last night, I woke up feeling strange. That strange feeling was being pain-free for the first time in almost four decades. It didn't last; I have some midl discomfort as I sit here typing this, but the intensity of pain has dminished by at least 80 percent, which is no small matter.

I am, however, afraid to take my blood pressure. Especially when I'm looking at three days without yoga. If you hear a loud BANG! it's probably my head exploding.


Jen said...

Very interesting! I have had both good and bad experiences with chiropractic and while the good definitely outweighed the bad, I'm not sure I'd do it again. Vigorous swimming four days a week seems to have done a lot more good for my upper back and shoulders than chiropractic, but it took two years to really start working, and not everybody's that patient.

I hope it works, tho. I have a brother in law with osteogenesis imperfecta, and among the many wacky things that have gone wrong, he missed a step on a staircase and jammed his spinal column into his skull hard enough that he needed emergency surgery to relieve the compression on his spinal cord. And he was just WALKING. If five or ten minutes of being tapped on fixes your problem, my friend, it is worth every cent you pay the man/woman.

BTW, I've never had hypertension but I did have a head injury when I was about 20 that resulted in a concussion, and I think may have worsened my pre-existing depression. Brains are strange things.

Janet said...

I hope it all works out for you. It sounds like you've already reaped some benefits.

Alis said...

David, this NUCCA (so should be a plant) sounds little short of miraculous, and when it's backed up by the kind of scientific trialling this has had surely it's got to be a good thing.
I'm quite surprised at the once-for- all-time view on the adjustemnt, though. Does the body, after four decades, not want to return to the status quo it's known so long and need a little persistent re-positioning?

Either way, I really do hope this works for you, the whole labile hypertension thing sounds awful.

David Isaak said...

Hi, Jen--

Yeah, I'm not overly impressed with the field of chiropractic either. But these folks are a little different--very specific, and they only do this one little thing. Nor do they claim that everyone can benefit. I suspect this technique will be subsumed into general medicine as time goes on.

Brains are not only strange things, but possibly the strangest of things.

David Isaak said...

Hi Janet--

Whether or not it does anything to my blood pressure, I already feel vastly better. So the money was well spent even if it doesn't solve the main problem...

David Isaak said...

Hi, Alis--

Yeah, some people require a few adjustments to get it to stabilize. But not always, or even usually.

Apparently it works like this: When your upper cervical vertebra gets pushed out of place by an injury, it presses on the brainstem. The rest of the body realigns to try and prevent it from pressing too hard. Level the top vertebra out and the rest of the body backs off.

The effect is very, very weird indeed. I feel as if I can't remember what my 'normal' posture is. I'm actually a little taller. I'm not quite sure how my shoulders 'usually' go. So my body feels very unsure of itself, but it doesn't seem inclined to go back to the state it has been in for the last four decades--probably because it had to work so hard to maintain that weird alignment.

Strange, strange, strange.

sexy said...



Jeff said...

Thanks for posting your experiences with NUCCA. It's hard as hell to find information about it online. I'm going to see a NUCCA doc within the next week here in Chicago (basically the head honcho) for a chronic back/shoulder problem. It's heartening to hear about your success.

David Isaak said...

Hi, Jeff--

Good luck with that. The NUCCA definitely worked for me; with some exercise, my blood pressure came down and stayed down. And I didn't need any further adjustments--the initial one stuck.